[701-0662-00 L] Environmental Impacts, Threshold Levels and Health Effects Lecture 9: Noise Part 3 (29.04.2020) Mark Brink ETH Zürich D-USYS Homepage: http://www.noise.ethz.ch/ei/
Topics covered in the previous lecture • Physical and subjective description of sound • Equal loudness curves • Sound pressure level (SPL): measurement • Common sound pressure level measures • Practical demonstration with noise level meter • Introduction to noise exposure • Brief overview over noise sources and noise abatement • Calculation of noise exposure • Common "noise metrics" L Aeq , L DEN , L DN • Noise maps D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 2
Lecture overview for today ► Health effects of noise (overview) ► Types of noise effects ► Auditory and non-auditory effects of noise ► DALY concept in environmental epidemiology ► Exposure assessment in environmental epidemiology ► Noise annoyance (introduction) ► Exposure-response relationships for noise annoyance ► Exposure-response curves ► Moderator variables ► Explained variance ► Setting of exposure limits D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 3
Overview of health effects of noise D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 4
to read: Basner, M., et al. (2013). "Auditory and non-auditory effects of Effects of noise on health noise on health." The Lancet 383(9925): 1325-1332. (Aircraft) Noise Non- Auditory auditory Effects effects physical psychological physiological Activation of the CNS Annoyance TTS Disturbance of activities Awakening Hearing damage Eliciting "stress" responses Distraction Long term health effects Performance impairments D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 5
Hierarchy of (non-auditory) noise effects Mortality Somatic health Morbidity endpoints e.g. Cardiovascular outcomes Abnormal changes of functions e.g. Awakenings Normal physiological reactions e.g. Annoyance Psychological appraisal and change of behavior Number of people affected D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 6
Average levels versus effects Physical damage Damage to hearing Long term health effects Effects on cognitive performance Effects on communication Effects on learning and concentration Sleep disturbances 20 40 60 80 100 120 Average level in dB(A) D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 7
Relevant (non-auditory) effects of noise • Noise annoyance • "Disturbances" (e.g. of communication) • Impairment of cognitive performance • Physiological activations (e.g. release of stress hormones, heart rate increases, in general: "stress responses") • Sleep disturbances (e.g. awakening reactions) • Long-term health endpoints (e.g. cardiovascular diseases, hypertension, myocardial infarction, stroke) • Social and economic effects (e.g. depreciation of properties, spatial segregation etc.) D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 8
Noise in the environmental epidemiology context Annual health loss expressed in disability-adjusted life years (DALYs) (Netherlands) 28 750 D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 9
DALY: Disability adjusted life years D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 10
WHO estimates of the burden of disease from noise for Western Europe (in DALYs) (2011) Source: WHO Europe (2011) Burden of disease from environmental noise D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 11
The DALY concept in environmental epidemiology DALYs = "Disability Adjusted Life Years" Promoted by the WHO and the World Bank A common measurement unit for morbidity and mortality used for public health assessments Facilitates comparisons of all types of health outcomes Combines information about loss of quality of life with traditional epidemiological information on mortality DALYs are used by the WHO to quantify the burden of disease D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 12
The DALY concept in environmental epidemiology Source: WHO D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 13
The DALY concept in environmental epidemiology Disability-adjusted life years lost out of 100,000 due to any cause in 2004 Source: WHO D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 14
Fractions of deaths and DALYs attributable to the environment Deaths 2012 DALYs 2012 Source: WHO (2016) Preventing disease through healthy environments D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 15
The DALY concept in environmental epidemiology Example A scenario: At the age of 40, having a statistical life expectancy of 80 years, a man gets cancer which disables him for a certain amount but after a surgery he is in remission for 10 years. Then he suffers from a progress of another disease which disables him substantially more. At the age of 70 years he dies. DALY = (10 x 0.1) + (20 x 0.4) + (10 x 1) = 18 QUALY = 80-18 = 62 start cancer & surgery new disease 0 Disability weight DALYs 0.5 premature death (QUALYs) 1 Age in years 0 10 20 30 40 50 60 70 80 D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 16
The DALY concept in environmental epidemiology Annual health loss in DALYs for selected environmental exposures in the Netherlands DALY 28 750 Source: De Hollander et al. (1999) D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 17
The DALY concept in environmental epidemiology Effect of noise on cognitive performance in school children in Switzerland (Year 2010) - expressed as DALYs DALY Noise from… Road traffic Railways Aircraft Source: BAFU/Ecoplan (2014) D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 18
WHO DALY estimates for Western Europe (2011) Source: WHO Europe (2011) Burden of disease from environmental noise D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 19
Epidemiologic noise exposure assessment D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 20
How to best assess noise exposure in epidemiology studies? • No (direct) accumulation of noise in the body... • Which characteristics of noise are best correlated with health effects? • Candidates: Noise exposure indicators L DN , L DEN , L max ; Frequency spectrum; Psychoacoustic features; Distribution of L max ; NNI (Noise and Number Index); Intermittency Ratio (IR)... • Are there "safe" noise levels below which no effects are observed? D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 21
"Errors" in noise exposure assessment ▪ The term error has a different meaning in epidemiologic exposure assessment than in everyday language ▪ Errors are unavoidable ▪ "Error" does not necessarily mean that something was done wrong ▪ Errors belong inherently to exposure assessment (and epidemiology) ▪ Important to evaluate effect and magnitude of errors on the study results Observed or measured exposure = True exposure ± bias ± random errors D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 22
Types of exposure assessment errors (in noise research) Type: Definition: Possible reason (example): random measured value is randomly measurement or (non-differential) scattered around true value calculation error systematic measured value is on average inaccurate calibration higher or lower than the true of sound level meter value differential Probability of being noise exposure misclassified differs across calculation at groups of study subjects locations close to airport is more accurate than far away from airport D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 23
Effects of random error in exposure measurements xls Simulation, Step 0: True values (measured values=real values) 12 y = 0.2698x - 9.2287 R 2 = 0.9536 10 8 Effect (Annoyance) linear fit 6 4 2 0 35 40 45 50 55 60 65 70 75 80 Exposure (dB) D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 24
Effects of random error in exposure measurements Simulation, Step 1: Introduce random error up to 3 dB 12 y = 0.2564x - 8.4924 R 2 = 0.8962 10 8 Effect (Annoyance) 6 4 2 0 35 40 45 50 55 60 65 70 75 80 Exposure (dB) D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 25
Effects of random error in exposure measurements Simulation, Step 2: Introduce random error up to 6 dB 12 y = 0.2582x - 8.7068 R 2 = 0.7797 10 8 Effect (Annoyance) 6 4 2 0 35 40 45 50 55 60 65 70 75 80 Exposure (dB) D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 26
Effects of random error in exposure measurements Simulation, Step 3: Introduce random error up to 9 dB 12 y = 0.1963x - 5.197 R 2 = 0.715 10 8 Effect (Annoyance) 6 4 2 0 35 40 45 50 55 60 65 70 75 80 Exposure (dB) D- USYS • M. Brink • Environmental Impacts - Noise Part 3 Slide 27
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